ObjectiveTo observe the clinical characteristics of patients with systemic intraocular lymphoma (IOL). MethodsA retrospective clinical study. From January 2016 to December 2024, 14 patients (23 eyes) who were diagnosed with system-IOL at Beijing Tongren Hospital, Beijing Intech Aier Eye Hospital, and Beijing Aier Eye Hospital were included in the study. Data on medical history, pathological subtype, ocular manifestations, treatment, and clinical outcomes were collected. The clinical features, therapeutic approaches, and prognosis were retrospectively analysed. The 1-year survival rate after ocular involvement was estimated using the Kaplan-Meier method. ResultsAmong the 14 patients, 5 were male and 9 were female, with a mean age of (57±9) years. Nine patients, involving 14 eyes, had a confirmed history of systemic lymphoma before the onset of IOL, whereas 5 patients, involving 9 eyes, initially presented with ocular symptoms and were subsequently found to have concomitant systemic lymphoma. Systemic lesions involved the lymph nodes, breast, adrenal gland, testis, spine, nasal region, gingiva, chest wall, and submandibular mass in 4, 2, 2, 1, 1, 1, 1, 1, and 1 patient, respectively. Diffuse large B-cell lymphoma (DLBCL) and natural killer/T-cell lymphoma were identified in 11 and 3 patients, respectively. One patient had composite lymphoma, with ocular DLBCL and systemic natural killer/T-cell lymphoma; the pathological subtype of systemic and ocular lymphoma was concordant in 13 patients. The interval from systemic lymphoma to ocular involvement was 4.2 (1, 14) years. Among the 23 eyes, keratic precipitates were observed in 13 eyes (56.5%, 13/23), varying degrees of anterior chamber inflammation in 11 eyes (47.8%, 11/23), and vitreous opacity in all 23 eyes (100.0%, 23/23). Vitreous infiltration was the predominant manifestation in 4 eyes (17.4%, 4/23), whereas retinal infiltration was observed in 19 eyes (82.6%, 19/23). Systemic treatment included systemic chemotherapy, local radiotherapy, chimeric antigen receptor T-cell therapy, and autologous stem cell transplantation. Intravitreal chemotherapy was administered to 8 patients involving 14 eyes. After treatment, regression of ocular lesions and improvement in visual acuity were observed in 11 eyes. Visual acuity decreased in 2 eyes, including 1 eye with optic nerve infiltration and 1 eye in a patient with newly detected systemic lesions. Among the 14 patients, 3 were lost to follow-up and 2 died. The 1-year survival rate after ocular involvement was 84.6%. ConclusionsDLBCL is the most common pathological subtype of systemic-IOL, followed by T-cell lymphoma. Ocular involvement in systemic-IOL may also present as a vitreoretinal pattern, characterised by vitreous opacity and retinal infiltration, with a relatively high proportion of anterior segment inflammation. Intravitreal chemotherapy may effectively induce regression of intraocular lesions and improve visual acuity. In cases with suboptimal treatment response, newly developed ocular lesions and systemic disease progression should be carefully considered.
ObjectiveTo preliminary investigate the association between systemic inflammatory biomarkers such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and diabetic retinopathy (DR). MethodsA cross-sectional study. A total of 5 999 patients diagnosed with diabetes in the NHANES database during the survey periods from 1999 to 2018 were included in the study. They were divided into the DR group (1 331 cases) and the non-DR group (4 668 cases) based on the presence or absence of DR. Demographic and laboratory data (including complete blood count, blood glucose, and lipid profiles) were collected, and NLR, PLR, and SII were calculated. The survey weights were used to handle the complex sampling design. After adjusting for confounding factors such as C-reactive protein, a weighted multivariate logistic regression model was applied to analyze the association between the logarithmically transformed and quartile-categorized NLR, PLR, SII and DR, and the odds ratio (OR) and its 95% confidence interval (CI) were calculated. Restricted cubic spline (RCS) was used to analyze the dose-response relationship, and subgroup analysis and interaction tests were conducted through Bonferroni correction. ResultsAfter multivariate adjustment, logistic regression analysis showed in the fully adjusted model with log transformation, neither SII (OR=1.160, 95%CI 0.756-1.780), NLR (OR=0.834, 95%CI 0.669-1.040), nor PLR (OR=1.360, 95%CI 0.859-2.154) showed statistically significant linear associations with DR (P＞0.05). RCS analysis indicated that SII showed no statistically significant overall association with DR (Poverall=0.062), but a non-linear relationship was observed (Pnon-linear=0.045). There was a significant non-linear dose-response relationship between PLR and DR (Poverall=0.011, Pnon-linear=0.009); and there was also a significant non-linear dose-response relationship between NLR and DR (Poverall=0.017, Pnon-linear=0.035). Subgroup analysis revealed that the absence of significant associations between SII, NLR, PLR and DR remained stable across different subgroups. ConclusionBased on a large sample cross-sectional study using the NHANES database, no independent linear association is found between PLR, NLR or SII and DR, and the results remain consistent across various subgroups.
ObjectiveTo observe the image characteristics of optical coherence tomography (OCT) in patients with primary vitreoretinal lymphoma (PVRL).MethodsA retrospective clinical study. Thirty-two eyes of 19 patients diagnosed with PVRL by vitreous pathology in the Department of Ophthalmology, Beijing Tongren Hospital from September 2016 to October 2019 were included in this study. There were 7 males and 12 females. The median age was 56 years. The mean time from symptom onset to final diagnosis was 6.1±3.8 months. The first diagnosis was uveitis in 12 cases (63.1%, 12/19), retinal vein occlusion in 2 cases (10.5%, 2/19), central retinal artery occlusion in 1 case (5.3%, 1/19), and suspected PVRL of camouflage syndrome in 4 cases (21.1%, 4/19). Routine ophthalmic examination and frequency-domain OCT examination were performed in all the patients, and typical images were stored for analysis. According to the examination results, PVRL OCT signs were divided into vitreous cells, inner retinal infiltration, outer retinal infiltration, retinal pigment epithelial (RPE) infiltration, sub-RPE infiltration, and subretinal fluid.ResultsVitreous cells were found in all eyes (100.0%, 32/32). RPE infiltrated were observed in 19 eyes (59.4%, 19/32), RPE infiltration in 16 eyes (50.0%, 16/32), outer retinal infiltration in 8 eyes (25.0%, 8/32), inner retinal infiltration in 16 eyes (50.0%, 16/32), and subretinal fluid in 4 eyes (12.5%, 4/32).ConclusionsPVRL OCT signs can involve vitreous and retinal anatomical levels, including vitreous cells, inner retinal infiltration, outer retinal infiltration, RPE infiltration, sub-RPE infiltration and subretinal fluid. The same patient can show multiple signs at the same time.
